Method and device for navigating active surgical instruments

ABSTRACT

A method for detecting a position. and. an operating state of an active surgical instrument. The active surgical instrument emits or influences/modifies at least one electromagnetic field in an active operating state. The method includes the steps of positioning a first sensor in order to detect the electromagnetic field emitted or influenced by the active surgical instrument is the active operating state at a known position, detecting the electromagnetic field emitted or influenced by the active surgical instrument in the active operating state by means of the first sensor, generating an output signal by means of the first sensor, the output signal indicating the detection of the electromagnetic field emitted or influenced by the active surgical instrument by means of the first sensor, and ascertaining the position and operating state of the active surgical instrument on the basis of the output signal and the known position of the first sensor.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.14/915,318 filed on Feb. 29, 2016, which is the U.S. National Stage ofInternational Application Number PCT/EP2014/068447 filed on Aug. 29,2014, which application claims priority under USC § 119 to German PatentApplication No. 102013217328.8 filed on Aug. 30, 2013. All applicationsare hereby incorporated by reference in their entirety.

TECHNICAL FIELD

The invention relates to a method for detecting a location and operatingstate of an active surgical instrument in a work region by means of asensor, the active surgical instrument emitting at least oneelectromagnetic field in a switched-on operating state and theelectromagnetic field being detected by the sensor. Furthermore, theinvention relates to a medical system for localizing active surgicalinstruments in a work region, with at least one active surgicalinstrument that is embodied to emit an electromagnetic field in theactive operating state.

BACKGROUND

In invasive surgical interventions, surgical instruments are moved in anoperating region in the interior of a patient by a surgeon during anoperation. An operating region refers to the space in the interior ofthe patient which, potentially or effectively, is affected by theemployed surgical instruments during the operation. The operationincludes the insertion and removal of surgical instruments into the bodyof the patient and out of the body of the patient, as well as themovement of the surgical instruments within the body of the patient andthe use of the surgical instruments in an intervention region which isarranged in the operating region and precisely predefined. Theintervention region refers to the part in the operating region which isto be worked on by the surgeon. By way of example, this can relate tothe tissue to be removed or vessels to be closed. Accordingly, anoperating region may comprise a plurality of intervention regions. Amultiplicity of sensitive structures lie next to the interventionregions in the operating region and they are to be preserved from damageby the surgical instruments. The sensitive structures include, forexample, vessels, organs, nerves, muscles, ligaments, sinews and other,generally intact tissue which is intended to be maintained in order torestrict the effects of the operation to a necessary minimum, as anyfurther impairment of the body of the patient during the operation mayincrease the health risk to the patient and have a negative influence onthe result of the operation.

Therefore, position detection systems are regularly used when performinginvasive surgical interventions. Position detection systems assist thesurgeon when establishing the position—i.e. the location andalignment—of surgical instruments in the operating region. Knownposition detection systems serve, in particular, to improve thenavigation of the surgical instrument into an intervention region in thebody of the patient, the navigation of the surgical instrument whilecarrying out an operative measure and the navigation of the surgicalinstrument out of the body of the patient. As a result of this, it ispossible to improve the result and the efficiency of the operation to becarried out. Moreover, precise navigation of the surgical instrument canreduce the risk of inadvertent impairment of, or damage to, surroundingtissue or neural pathways, potentially at risk, in the operating region.

Conventionally, position detection systems detect the location andalignment of at least one medical instrument, e.g. a surgicalinstrument, during the operation and transform the detected locationcoordinates such that a location and alignment of the instrument can besuperposed into e.g. images of the patient and, in particular, optionalspatial depictions of the intervention region. It is possible toestablish position information of a multiplicity of different surgicalinstruments in many position detection systems. The detected positioninformation is usually visualized on a monitor together with planningdata obtained presurgery and/or image data obtained during the surgery.To this end, sensors (which are also referred to as localizers) arearranged at determinable points of the patient and of the surgicalinstruments, the output signals of which sensors are determinable asposition information in the operating region by an evaluation unit ofthe position detection system.

By way of example, it is known to provide different medical instruments,such as e.g. pointer instruments, suction devices, forceps, needles,scalpels, electrotomes, cauteries, and the like with localizers(instrument sensors) for establishing position information for such aposition detection system and to register the respective medicalinstrument in the position detection system. During the registration,the position of a reference point—usually the work point of theinstrument tip—is calibrated by means of a localizer (location sensor)at the instrument relative to a known point at the patient (or anobject) and transmitted to the position detection system. In thismanner, the alignment of the medical instrument and the position of thereference point determined by the position detection system can berelated to known points at the patient or an object in ordersubsequently to be able to transform the coordinates of the referencepoint of the instrument detected by the position detection system into acoordinate system underlying the image data of the patient. On the basisof this data, it is possible to depict on the monitor an image, true toposition, of the medical instrument together with the availablepresurgical and/or intraoperative image data.

Such position detection systems may comprise localizers which, forexample, operate optically, with ultrasound or in an electromagneticmanner. By way of example, position detection systems operating on thebasis of electromagnetic induction are known; these have a fieldgenerator, which is arranged next to the patient and generates agenerally alternating electromagnetic field in the work region. Alocalizer which has a plurality of sensor coils with a known relativeposition in relation to one another is arranged at a surgical instrumentto be navigated in the work region. The alternating electromagneticfield induces electric currents in these sensor coils in a mannerdependent on the alignment of the respective sensor coil in relation tothe alternating electromagnetic field, which currents are characteristicfor the alignment and location of the respective coil in the alternatingelectromagnetic field. An evaluation unit measures the induced currentsand, taking into account the known position of the coils in relation toone another, therefore establishes the position of the sensor coils inthe alternating electromagnetic field. During the registration orcalibration process, the instrument tip of the surgical instrumentshould initially be guided with a predetermined alignment to a referencepoint defined in the position detection system and the position of thelocalizer should be determined when the reference point is reached.Hence, the position in the work region of a surgical instrument equippedwith the sensor coils is determinable by the position detection system.

The aforementioned position detection systems are disadvantageous inthat they are substantially only suitable for detecting the position ofpassive surgical instruments such as e.g. scalpels or scissors. Activesurgical instruments, such as e.g. drills, cauteries or oscillatingsaws, emit an electromagnetic field, which is superimposed on thealternating electromagnetic field from the field generator, and theinterferences resulting therefrom can have a direct effect on thecurrent induced in the sensor coil. This leads to falsification of theposition data of the sensor coil, and hence of the surgical instrument,established by the evaluation unit. Moreover, active surgicalinstruments in an active operating state harbor an increased risk ofdamage to adjacent tissue by way of the active instrument part.

WO 02/076302 has disclosed a method and a device system for tissueablation and for tissue treatment, wherein the position of an activesurgical instrument in the operating region is detected by way of anoptical position determination apparatus and the tissue ablation and thetissue ablation rate in the intervention region are determined on thebasis of the therefore determinable change in position of the activesurgical instrument. The operation progress is establishable on thebasis of these data and the operating state of the active surgicalinstrument is controllable. Here, the power of the active surgicalinstrument can be throttled in the case of the imminent achievement ofthe operation target, i.e. the performed ablation of a predeterminedtissue volume, and the active surgical instrument can be switched offwhen the operation target is reached.

A disadvantage of this method and device system is that use is only madeof optical position detection means which, on account of a restrictedfield of view and strong dirtying of the sensors, e.g. by blood, in theoperating region, are not suitable for many surgical interventions.Moreover, the closed-loop control of the operating state of the activesurgical instrument merely takes into account the operation progress;sensitive structures which can potentially be damaged by the surgeon arenot taken into account.

Therefore, the present invention is based on the object of providing amethod and a medical system for detecting a location and operating stateof active surgical instruments in a work region, which enable a moreprecise establishment of the location of the active instrument in thework region than what is known from the prior art and which reduce therisk of inadvertent damage by the active surgical instrument to objectsarranged in the work region, in particular in an active operating stateof the active surgical instrument.

SUMMARY

According to the invention, this object is achieved by a method fordetecting a location and operating state of an active surgicalinstrument, the active surgical instrument emitting at least oneelectromagnetic field or influencing and therefore modifying a givenelectromagnetic field in a switched-on operating state. The methodcomprises the following method steps: positioning at least one firstsensor for detecting at a known location the electromagnetic fieldemanating from the active surgical instrument in the active operatingstate thereof, detecting by means of the at least one first sensor theelectromagnetic field emanating from, or changed by, the active surgicalinstrument in the active operating state thereof, generating an outputsignal by the at least one first sensor, the output signal indicatingthe detection by the at least one first sensor of the electromagneticfield emanating from, or changed by, the active surgical instrument; andestablishing a location and operating state of the active surgicalinstrument on the basis of the output signal or the output signals andthe known location or locations of the at least one first sensor.

Instead of explicitly establishing a location and operating state of theactive surgical instrument, it is also possible to directly use theoutput signal of the at least one first sensor indicating the strengthof, or change in, the electromagnetic field in order, for example, tocontrol the operating state of the active surgical instrument since theoutput signal always contains information about a relative vicinitybetween an instrument and a first sensor and therefore also alwaysimplicitly contains location data.

Thus, provision can be made for one or more first sensors. Therefore,the first sensor can either directly detect an electromagnetic fieldemanating from the active surgical instrument or detect a change in asurrounding electromagnetic field caused by the active operating stateof the active surgical instrument; if necessary, both options are alsopossible. It is expedient to determine the dependence of theelectromagnetic field emitted or changed by the active surgicalinstrument on the operating state of the active surgical instrument byway of a reference measurement. To this end, field parameters such ase.g. strength and frequency of the electromagnetic field are taken intoaccount as a function of the operating state. A family ofcharacteristics of the active surgical instrument is generable from themeasurement data of the reference measurement. This family ofcharacteristics should be accordingly taken into account whendetermining the location and the operating state of the active surgicalinstrument.

Preferably, the output signal generated by the respective first sensorhas a signal vale or level which indicates a strength detected by therespective first sensor or the degree of the change in theelectromagnetic field of the active surgical instrument. As a result ofthis, it is possible to draw conclusions from the signal value or levelof the output signal about the strength of, or the change in, thedetected electromagnetic field at the sensor. Hence, a quantitativereflection of the strength of, or the change in, the detectedelectromagnetic signal is possible. If a location of the first sensor, acharacteristic of the electromagnetic field and a ratio between detectedstrength of, or change in, the electromagnetic field and the strength ofthe output signal of the first sensor are known, the location of thesurgical instrument in the work region is accordingly established on thebasis of the signal value or level of the output signal of the firstsensor. More precise location data can be generated with a plurality offirst sensors, for example in the style of a triangulation.

The level of the output signal generated by the respective first sensorreflecting the detected strength of, or change in, the electromagneticfield of the active surgical instrument can be used in differentadvantageous ways, for example for automatically influencing the activesurgical instrument, or else for generating a signal perceivable by amedical practitioner and indicating to the medical practitioner theapproach of the active surgical instrument to a target region. Such aperceivable signal may be e.g. optical or acoustic, for example a sound,the frequency and/or modulation of which changes with an (optionally tooclose) approach to a target structure or by optical highlighting ofcritical structures in a computed tomography image obtained presurgeryor intraoperatively. Particularly preferably, different operating statesof the active surgical instrument are detected and taken into accountwhen establishing the location of the active surgical instrument.

Apart from the detected strength of, or change in, the electromagneticfield, the automatic influencing of the active medical instrument or thegenerated perceivable signal can also depend on the activity state ofthe active medical instrument. In the case of an acoustic signal, thefrequency can e.g. indicate the detected strength of the electromagneticfield, while a modulation (e.g. uninterrupted sound vs. interruptedsound) can simultaneously indicate the activity state of the activemedical instrument.

In particular, it is possible to generate a warning signal when,depending on the activity state of the active medical instrument, thereis an approach to a target structure that is too close.

It is preferable for the operating state of the active surgicalinstrument to be controlled in a manner dependent on the generatedoutput signal.

More preferably, the active surgical instrument is throttled if thefirst sensor detects a strength of, or a change in, the electromagneticfield that exceeds a selected first threshold. By way of example, thethrottling can be carried out as a function of the detected strength ofthe electromagnetic field. What is ensured hence is that the operatingstate of the active surgical instrument is controllable in a mannerdependent on the location of the active surgical instrument in the workregion. Moreover, an unnecessary power uptake of the active surgicalinstrument can be reduced and inadvertent damage of objects in the workregion by the active surgical instrument can be prevented.

If the output signal of the first sensor reflecting the strength of, orchange in, the electromagnetic field for example indicates an approachto possibly sensitive target structures, the active surgical instrumentcan also be controlled in such a way that there is hapticallyperceivable feedback, e.g. an intermittent operation of the activesurgical instrument which can be perceived by a medical practitionerbecause the device “jerks”.

Particularly preferably, the active surgical instrument is switched offif the first sensor detects a strength of, or a change in, theelectromagnetic field that is greater than a selected second threshold.The second threshold is greater than the first threshold. What can beprevented by this measure is the active surgical instrument having anactive operating state in the case of an unwanted collision with anobject in the work region and the object being damaged thereby.

Preferably, a refresh rate of a display unit is set in a mannerdependent on the established operating state of the active surgicalinstrument. In this manner, e.g. the characteristic of the cutting edgesof the active surgical instrument is displayable in an improved mannerfor an operating person.

Particularly preferably, a rotational speed of a work tip of the activesurgical instrument corresponds to an integer multiple of the setrefresh rate. When the rotational speed of the work tip of the activesurgical instrument is changed, the refresh rate of the display isadapted accordingly in order always to correspond to an integer multipleof the rotational speed of the work tip of the active surgicalinstrument.

More preferably, the position data of the active surgical instrument isdetected by a position detection unit by means of an instrument sensor(i.e. a localizer at the instrument) arranged at the active surgicalinstrument. The position comprises both the location in space and thealignment. To this end, the instrument sensor can comprise e.g. sensorcoils and the position determination unit can comprise a field generatorwhich generates an alternating electromagnetic field in the work region.This is advantageous in that the position of the active surgicalinstrument in the work region is also determinable when the activesurgical instrument is in an inactive operating state.

Preferably, there is a comparison of the location data, detected bymeans of the first sensor, and the position data, detected by means ofthe instrument sensor, of the active surgical instrument and/or alocation correction value is formed from associated location-positiondata pairs. Therefore, it is possible e.g. to correct interferences ofthe electromagnetic field of the active surgical instrument in analternating electromagnetic field of the position determination unit,which can lead to errors when determining the position. As a result ofthis measure, the accuracy of determining the position of the activesurgical instrument can be improved.

Since an electromagnetic field emanating from an active medical devicecan impair an exact detection of the location of the instrument by meansof an instrument sensor, provision can be made of a plurality of firstsensors for a more exact detection of the position, said first sensorsenabling a detection of the position e.g. by way of triangulation.

Alternatively or additionally, the active medical instrument can also beequipped with one or more ultrasonic sensors. With the aid of anultrasonic sensor, it is possible, in a manner known per se, to detectchanges in density in the tissue in an image-like manner. The advantageof this is that such images obtained by means of ultrasound are notdisturbed by electromagnetic fields.

Preferably, the operating state of the active surgical instrument istransmitted from the active surgical instrument and/or a control unit ofthe active surgical instrument to the location detection unit and/orposition detection unit. Due to the thus obtained parameter of theoperating state of the active surgical instrument, the locationdetection unit and/or position detection unit can monitor the family ofcharacteristics of the active surgical instrument by means of the outputsignal generated by the first sensor and carry out a new calibration ofthe active surgical instrument in the case of a pre-definable deviation.

Moreover, the aforementioned object is achieved by a medical system forlocalizing active surgical instruments in a work region, with at leastone active surgical instrument, the active surgical instrument beingembodied to emit an electromagnetic field in the active operating state.The medical system has a location detection unit for establishing thelocation of the active surgical instrument in the work region and atleast one first sensor. The first sensor is arrangeable at a knownlocation in the work region and embodied to detect the electromagneticfield of the active surgical instrument and to transmit an output signalindicating the detected parameters of the electromagnetic field to thelocation detection unit, the location detection unit being embodied toestablish the location of the active surgical instrument on the basis ofthe output signal and the location of the first sensor.

Preferably, the medical system has a position detection system with aposition detection unit, a field generator and an instrument sensor, theinstrument sensor being arrangeable or arranged at the active surgicalinstrument and embodied to detect an alternating electromagnetic fieldgenerated by the field generator and to transmit a signal indicating thedetected alternating electromagnetic field to the position detectionunit. The position detection unit is embodied to establish position dataof the active surgical instrument on the basis of the detected signaland the known alternating electromagnetic field generated by the fieldgenerator.

Preferably, the location detection unit and/or position detection unitis configured to compare the location data and the position data of theactive surgical instrument and to establish a corrected location and/orposition of the active surgical instrument therefrom. Therefore, aposition of the active surgical instrument determined incorrectly as aresult of interference between the electromagnetic field of the activesurgical instrument and the alternating electromagnetic field of thefield generator can be corrected.

Preferably, the medical system has a display unit for depicting, true tothe position, at least one active surgical instrument detected by theposition detection unit in the work region and obtained image data of anobject arranged in the work region. The image data can comprise bothindividual images, such as e.g. x-ray images or CT recordings, and videoimages, with the medical system preferably being embodied to recordvideo images and display these without delay, where possible, or onlywith little delay.

In an advantageous embodiment of the invention, the medical system has adata interface for transmitting the operating state of the activesurgical instrument from the active surgical instrument and/or aninstrument control unit of the active surgical instrument to theposition detection unit and/or location detection unit. The datainterface can be embodied for wired or wireless transmission, e.g. byradio or optically, of the operating state of the active surgicalinstrument.

Preferably, the active surgical instrument has an electric motor which,depending on the operating state of the active surgical instrument,emits an interference signal. Conventional electric motors have a magnetand coils, and are based on the principle of induction. Therefore, theyhave an electromagnetic field during operation, which is detectable bysensors.

BRIEF DESCRIPTION OF THE DRAWINGS

The invention is intended to be explained in more detail below on thebasis of an exemplary embodiment, with reference being made to thedrawing. In detail:

FIG. 1 shows a schematic view, not necessarily to scale, of a medicalsystem according to the invention for localizing and for determining theoperating state of active surgical instruments.

FIG. 2 shows a flow chart corresponding to the steps of the medicalsystem according to the invention for localizing and determining theoperating state of active surgical instruments.

DETAILED DESCRIPTION

A medical system according to the invention which is embodied todetermine the location of an active surgical instrument comprises atleast one location detection unit and a first sensor 20. A medicalsystem for determining the position of an active surgical instrument 10in a work region is e.g. expandable using this medical system. Such amedical system for determining the position of an active surgicalinstrument comprises a position detection unit, a field generator 24 foremitting an alternating electromagnetic field 22 in a work region, aninstrument sensor 16 and a display unit 32 for displaying, true toscale, the active surgical instrument 10. In the active operating state,the active surgical instrument 10 emits an electromagnetic field 14.

The medical system in accordance with the exemplary embodiment depictedin FIG. 1 comprises an active surgical instrument 10, which is embodiedas a surgical drill. The active surgical instrument 10 has a handle 11and an actuator 13, arranged at the handle 11, for setting therotational speed of an instrument tip 18. For the purposes of drivingthe instrument tip 18, the active surgical instrument 10 has an electricmotor 12 which is covered in this illustration, wherein the electricmotor 12 is arranged in the vicinity of the instrument tip 18 and itemits the electromagnetic field 14 during operation. The instrument tip18 is held detachably at the active surgical instrument by way of aclamping apparatus 15. Hence, the instrument tip 18 can easily bedisassembled due to e.g. wear and tear or dirtying and it can bereplaced by a new instrument tip 18 or returned to a state whichsatisfies the requirements of the instrument tip 18.

During operation, the electric motor 12 emits an electromagnetic field14 which is depicted symbolically in the figure by concentric circlesegments. The electromagnetic field 14 propagates in a substantiallyspherical manner from the electric motor 12 and has a field frequencyand a field strength. The active surgical instrument 10 is connected toan instrument control unit 38 by means of an instrument cable 40. Theinstrument control unit 38 supplies power to the active surgicalinstrument 10 by way of the instrument cable 40.

A first sensor 20 for detecting the electromagnetic field 14 isconnected to a navigation unit 30 by way of a sensor line 26. In thisembodiment, the navigation unit 30 comprises a location detection unitand a position detection unit. Alternatively, the location detectionunit and position detection unit can also be embodied as separatemodules such that, for example, a medical system which already has aposition detection unit can, without much outlay, be complemented by alocation detection unit with a first sensor.

The first sensor 20 is arrangeable in a work region, e.g. in thevicinity of an object (not depicted here), with the object beingpotentially damageable by the instrument tip 18, particularly in theactive operating state of the active surgical instrument. When theactive surgical instrument 10 in the active operating state approachesthe first sensor 20, the electromagnetic field 14 induces a current inthe first sensor 20 which, as an output signal, is transmitted to thenavigation unit 30 by way of a sensor line 26. Since the position dataof the first sensor 20 in the work region are known, the navigation unit30 can determine the location of the electric motor 12 and hence alsothe location of the active surgical instrument 10 in the work region dueto the characteristic of the received output signal of the first sensor20. If no signal is received by the first sensor 20, this means eitherthat the active surgical instrument 10 is too far away from the firstsensor 20 or that it is in the passive operating state, i.e. switchedoff

For the purposes of visualizing the determined location data of theactive surgical instrument 10, the navigation unit 30 is connected to adisplay unit 32 by way of a monitor cable 34. Hence, it is possible todisplay e.g. the instrument tip 18 on the display unit. Expediently,these image data are depicted on the display unit 32 in a mannersuperposed with further image data, such as e.g. CT, x-ray or videoimage data, of the operating region of the patient, which are obtainedeither presurgery or intraoperatively.

The navigation unit 30 is connected by way of a generator cable 28 to afield generator 24 which generates an alternating electromagnetic field22 depicted schematically in the figure by means of concentric circularsegments. This alternating electromagnetic field 22 is detectable by aninstrument sensor 16 arranged in the vicinity of the instrument tip 18at the active surgical instrument 10. A current is induced in theinstrument sensor 16 by the alternating electromagnetic field 22 in amanner dependent on the position of the instrument. sensor 16, saidcurrent being transmitted by way of the instrument cable 40 to theinstrument control unit 38. By way of a connection cable 36, thisinduced current is forwarded to the navigation unit 30 and evaluatedthere in order to determine the position of the active surgicalinstrument 10 relative to the patient and display this on the displayunit 32. This additional option for determining the position isadvantageous in that the position of the active surgical instrument 10relative to the patient is also determinable if the active surgicalinstrument 10 is inactive and the electric motor 12 does not generate anelectromagnetic field 14. The system can be configured in such a waythat the field generator 24 is inactive or only operated in a pulsatingmanner if the active surgical instrument 10 is active and the electricmotor 12 generates an electromagnetic field 14 so as to prevent orcompensate possible measurement interference by interference between theelectromagnetic field 14 of the electric motor 12 and the alternatingelectromagnetic field 22 of the field generator 24.

If the location detection unit or navigation unit 30 determines that theactive surgical instrument 10 or the instrument tip 18 drops below afirst minimum distance from an object (not depicted in thisillustration) in the work region, a control signal can be transmittedfrom the location detection unit or navigation unit 30 to the instrumentcontrol unit 38 for the purposes of throttling the power of the activesurgical instrument 10. By way of example, this throttling can becarried out with jumps or continuously. The throttling can also becarried out directly at the active surgical instrument 10, withouttransmitting a control signal to the instrument control unit 38. To thisend, an e.g. preferably regulable resistor could be arranged at theelectric motor 12.

Alternatively or additionally, a warning, e.g. an acoustic or opticalsignal, can be output to the user. By way of example, there can be acolor change on the display unit 32 as an optical signal. The colorchange can also extend over a spectrum and it can be carried out in amanner dependent on the distance between the instrument tip 18 of theactive surgical instrument 10 and the object in the work region. As aresult of this, the user can be warned that a collision with an objectin the work region is potentially imminent and that the active surgicalinstrument 10 should be removed from this object again. By throttlingthe active surgical instrument 10, damage to the object by the activesurgical instrument in the case of a collision is reduced further.Furthermore, the throttling is also a haptic and/or possibly audibleand/or visible indication for the user that the active surgicalinstrument 10 has dropped below a first minimum distance to a specificobject in the work region.

If the location detection unit or navigation unit 30 furthermoredetermines that the active surgical instrument 10 has dropped below asecond minimum distance to the object in the work region, with thesecond minimum distance preferably being smaller than the first minimumdistance, a further control signal can be transmitted from the locationdetection unit or navigation unit 30 to the instrument control unit 38in order to deactivate the active surgical instrument 10. Alternatively,the active surgical instrument 10 can be switched off directly at theactive surgical instrument 10, for example by cutting the power supplyat the electric motor 12, and without the transmission of a controlsignal to the instrument control unit 38. As a result of this, the riskof damaging an object arranged in the work region by an active surgicalinstrument 10 in the case of a collision with a sensitive structure ofthe patient is reduced since the active surgical instrument 10 in thedeactivated operating state has fewer potential risks than in the activeoperating state. Moreover, as a result of the standstill of the activesurgical instrument 10, the operator is prompted to navigate the activesurgical instrument 10 away from the object in the work region.

A flow chart for the above-described methodology is shown in FIG. 2.

This exemplary embodiment is merely intended to schematically illustratethe subject matter of the present invention and not intended to restrictthe invention to this specific embodiment. Configurations are providedwithin the scope of the invention, in which the navigation unit 30 andthe instrument control unit 38 form a common unit. Wired connections mayoptionally also be replaced by wireless connections. The number ofsensors employed is expediently greater than the number in theillustrated exemplary embodiment in order to improve the accuracy of thenavigation system. By way of example, a first sensor can be a sensorunit and can likewise comprise a group of first sensors. Furthermore,means can be provided which regulate the characteristic of thealternating electromagnetic field 22 of the field generator 24 in amanner dependent on the characteristic of the electromagneticinterference field 14 of the electric motor 12.

LIST OF REFERENCE SIGNS

-   10 Active surgical instrument-   11 Handle-   12 Electric motor-   13 Actuator-   14 Electromagnetic field-   15 Clamping apparatus-   16 Instrument sensor-   18 Instrument tip-   20 First sensor-   22 Alternating electromagnetic field-   24 Field generator-   26 Sensor line-   28 Generator cable-   30 Navigation unit-   32 Display unit-   34 Monitor cable-   36 Connection cable-   38 Instrument control unit-   40 Instrument cable

1-15. (canceled)
 16. A method for detecting a location and operatingstate of a surgical instrument having an active operating state, and aninactive state, comprising: positioning a first sensor at a knownlocation, the first sensor configured to detect a first electromagneticfield emitted from the surgical instrument when in the active operatingstate; detecting the first electromagnetic field with the first sensor;generating an output signal from the first sensor, the output signalindicating the detection by the first sensor of the firstelectromagnetic field emitted from the surgical instrument in the activeoperating state; and establishing the location and the operating stateof the surgical instrument in the active operating state on the basis ofthe output signal and the known location of the first sensor; generatinglocation data, the location data corresponding to the establishedlocation; and controlling the operating state of the surgical instrumentbased on the output signal.
 17. The method of claim 16, wherein theoutput signal generated by the first sensor has a signal value thatindicates a change in the first electromagnetic field detected by thefirst sensor.
 18. The method of claim 16, wherein the output signalindicates that the surgical instrument is a minimum distance from anobject in a work region.
 19. The method of claim 18, wherein a warningis provided when a distance between the surgical instrument and theobject in the work region has dropped below the minimum distance. 20.The method of claim 16, wherein power to the surgical instrument isthrottled if the first sensor detects a strength of the firstelectromagnetic field that is greater than a selected first threshold.21. The method of claim 20, wherein the surgical instrument in theactive operating state is switched off if the first sensor detects thatthe strength of the first electromagnetic field is greater than aselected second threshold, the selected second threshold being greaterthan the selected first threshold.
 22. The method of claim 16, furthercomprising detecting a second alternating electromagnetic fieldgenerated by a field generator with an instrument sensor.
 23. The methodof claim 22, wherein there is a comparison of the location data,generated by the first sensor, and position data, wherein the positiondata corresponds to the position of the surgical instrument detected bythe instrument sensor, and wherein a location correction value is formedfrom associated location-position data pairs.
 24. The method of claim22, further comprising generating an induced current dependent on aposition of the instrument sensor, and evaluating the induced current soas to determine a position of the surgical instrument relative to apatient when the surgical instrument is in the inactive state.
 25. Themethod of claim 16, wherein a refresh rate of a display unit is set in amanner dependent on the established operating state of the surgicalinstrument.
 26. The method of claim 25, wherein a rotational speed of awork tip of the surgical instrument corresponds to an integer multipleof the set refresh rate.
 27. The method of claim 16, further comprisingdisplaying the surgical instrument on a display unit.
 28. The method ofclaim 27, wherein the displayed surgical instrument is superimposed onimage data.
 29. The method of claim 16, further comprising calibratingthe surgical instrument.
 30. A medical system for localizing and fordetermining an operating state of a surgical instrument in a work regionof a patient, the surgical instrument having an active operating stateand an inactive state, the surgical instrument when in the activeoperating state configured to emit a first electromagnetic field,comprising: a first sensor positioned at a known location in the workregion, the first sensor configured to detect the first electromagneticfield emitted from the surgical instrument when in the active operatingstate and configured to generate an output signal indicating thedetection by the first sensor of the first electromagnetic field; alocation detection unit, the location detection unit configured toestablish a location and the operating state of the surgical instrumentin the active operating state on the basis of the output signalgenerated by the first sensor and the known location of the firstsensor, and to generate location data; and a navigation unit configuredto determine a position of the surgical instrument relative to apatient, wherein the operating state of the surgical instrument iscontrolled by the output signal generated by the first sensor.
 31. Themedical system of claim 30, further comprising an instrument sensor onthe surgical instrument configured to detect a second alternatingelectromagnetic field generated by a field generator.
 32. The medicalsystem of claim 30, wherein the location detection unit is configured tocompare the location data and position data of the surgical instrument,and to establish a corrected location or corrected position of thesurgical instrument.
 33. The medical system of claim 30, wherein thenavigation unit is configured to compare the location data and positiondata of the surgical instrument, and to establish a corrected locationor corrected position of the surgical instrument.
 34. The medical systemof claim 30, further comprising a display unit for displaying thesurgical instrument in the work region of the patient.
 35. The medicalsystem of claim 30, further comprising a data interface configured totransmit the operating state of the surgical instrument from thesurgical instrument.